Improving prevention and treatment of heart failure in type 1 diabetes

People with type 1 diabetes who develop heart failure face worse outcomes than those without diabetes, yet the underlying biology remains poorly understood. This matters because most heart failure research has focused on type 2 diabetes, leaving a critical gap in knowledge for type 1 diabetes. The researcher proposes that damage to the tiny blood vessels supplying the heart—cardiac microvascular disease—may drive the worse outcomes. To test this, they will build a risk prediction tool to identify high-risk individuals, run an observational study to track how microvascular disease affects heart failure progression, and test whether a specific drug class (SGLT1/2 inhibitors) can repair those damaged vessels. If the research succeeds, it could transform how clinicians prevent and treat heart failure in type 1 diabetes. Instead of relying on approaches designed for type 2 diabetes, doctors could use targeted screening and therapies that address the distinct microvascular pathology. This would mean better survival and quality of life for a patient group currently underserved by existing treatments. The work is patient-centred and directly translational, aiming to change clinical practice within the fellowship period.